Organization Active NPI

Intown Midwifery, LLC

Doing business as Intown Midwifery

  • Advanced Practice Midwife
  • Stone Mountain, GA
National Provider Identifier
1902118334
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN029330 Issued in GA
Legal business name
INTOWN MIDWIFERY, LLC
Doing business as
Intown Midwifery
Practice address
5049 Bent Tree Loop
Stone Mountain, GA 30083-1538
Phone
(678) 770-0728
NPI assigned
Jul 14, 2010
Last updated
Jul 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Sheree McClure
Title
Admin Assist/Office Liaison
Phone
(678) 770-0728

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X RN184793 GA
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X RN184793 GA
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X RN029330 GA Primary

Addresses

Primary practice location

5049 Bent Tree Loop
Stone Mountain, GA 30083-1538

Mailing address

285 Boulevard NE
Ste 520
Atlanta, GA 30312-4205
Phone (404) 622-9810

Other identifiers 1

IdentifierTypeStateIssuer
00951651BMedicaidGA

Other names 1

  • Intown Midwifery Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1902118334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 BOULEVARD NE",
            "address_2": "STE 520",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124205",
            "telephone_number": "404-622-9810",
            "fax_number": "404-265-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5049 BENT TREE LOOP",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300831538",
            "telephone_number": "678-770-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTOWN MIDWIFERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "SHEREE",
        "authorized_official_title_or_position": "ADMIN ASSIST/OFFICE LIAISON",
        "authorized_official_telephone_number": "678-770-0728",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN184793",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN184793",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN029330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00951651B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intown Midwifery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.